Sleeve gastrectomy tied to higher GERD risk compared to gastric bypass: Study

Norway: Roux-en-Y gastric bypass (RYGB) is an effective anti-reflux surgery than sleeve gastrectomy (SG) for obese patients, a recent study in the journal Gastroenterology has found. 

According to the study, the prevalence of GERD and new-onset of esophagitis and pathological reflux were greater in patients who underwent SG compared to those who underwent RYGB. However, there were no difference in the risk of new-onset esophageal dysmotility between the groups.

Obesity is associated with impaired gastric emptying, increased intra-abdominal pressure, and decreased lower esophageal sphincter (LES) pressure -- all factors predispose for gastroesophageal reflux disease (GERD). Further, patients with type 2 diabetes and obesity have a high prevalence of esophageal motility disorders and GERD. 

Roux-en-Y gastric bypass is considered is an effective antireflux procedural, while sleeve gastrectomy may induce or worsen GERD. Previous studies that assessed GERD after SG were limited by unclear GERD definitions, and it is not clear if SG and affects GERD differently. To clarify the same, Jøran Hjelmesæth, Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway, and colleagues aimed to compare the 1-year effects of SG and RYGB on prespecified secondary GERD outcomes from the randomized controlled Oseberg trial, hypothesizing that those who underwent SG would have a higher 1-year risk of subjective and objective measures of GERD.